Welcome, Brokers!

Fidelis Care is pleased to announce that the new Quality Care Incentives (QCI) Program is now available on Provider Access Online. Once logged in, please navigate to the File Downloads section to access the brochure.

Fidelis Care is committed to ensuring that our members have access to essential preventive services that promote overall well-being and enhance their quality of life. As a contracted provider with Fidelis Care, your role is vital in helping us achieve this commitment.

For over 25 years, Fidelis Care has provided incentive payments to participating providers for delivering routine preventive care and promoting health among members. The organization remains dedicated to rewarding providers for achieving high-quality outcomes and has made significant changes to the program for Measurement Year (MY) 2025 to align with mutual goals.

HOW IT WORKS

For 2025, there will be several significant changes to the program:

• To improve payment delivery and provide better recognition to our providers, all incentives will be event-based for 2025, paying to the provider responsible for rendering care on a quarterly basis.

• Expanding the Well Visit incentive to existing members in HARP, CHP, and Medicaid, and increasing the incentives for Essential Plan measures.

This brochure provides an overview of our QCI Program components and coding specifications designed to enhance quality and facilitate reward attainment. You will receive monthly care gap reports to monitor performance and identify patients requiring attention.

For questions about Fidelis Care’s Quality Care Incentives, contact your Provider Partnership Associate. Find their contact info here: https://www.fideliscare.org/Provider/Provider-Resources/Quality